Wufoo

Committee on Representation Survey

To ensure fair and effective representation in the decision making of the Presbytery of Cincinnati, we need to know about YOU! Please complete and submit this form.

Name * First Last
Church *

Ministers not affliated with a particular church should choose "PRESBYTERY." CLPs, please indicate the church of your membership.
Office *
Deacon Elder Minister none

Check each office to which you have ever been ordained.
Groups *
Council Church Order Ministry Nominating PJC Personnel Preparation for Ministry Representation Trustees

Check each group to which you currently belong.
Categories based on G-4.0403 in the Book of Order
Racial Ethnicity *

List a few words that describe your racial ethnicity.
Gender *
Year of Birth *
Disabling Conditions
hearing impairment mobility impairment sight impairment other

Check each condition that substantially limits your participation in life's activities.
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Theological Position *

List a few words that describe your theology.
Do Not Fill This Out
Do Not Fill This Out

Wufoo

Committee on Representation Survey

Categories based on G-4.0403 in the Book of Order